1. Field of the Invention
The present invention relates to an exercise and therapy device. More particularly, the present invention relates to a device that provides exercise and therapy to a user.
2. Background of the Related Art
The brain area that is responsible for our sense of touch is called the somatosensory cortex. Hand and face regions are considerably more densely provided with touch receptors than the skin on the arms and on the trunk and therefore have a much larger image area in the somatosensory cortex. The neural projections are not rigid, but can change under the nuances of sensory experience or as the result of a loss of sensory input, e.g., after nerve damage. The necessary modifications of the connections between receptors and sensory neurons are thought to be, at least in part, activity driven. For example, experiments have revealed that frequent stimulation of skin regions leads to an expansion of their representation in the somatotopic map. (Jenkins et al., Chap. 7, Modeling the Somatotopic Map, pp. 101-117, 1984). Conversely, neurons whose receptors no longer receive any stimuli become sensitive to other receptors which are still active. (Kaas et al. 1983).
People who exercise their tactile abilities have an expanded representation of the trained body part in primary somatosensory cortices. For instance, Braille readers show superior tactile abilities as a group, and have enlarged somatosensory representation of the right index finger, which is used in Braille reading, compared to the left index finger, which was not used in reading. (Pascual-Leone & Torres, 1993). Likewise, professional string players have tactile stimulation of left hand digits, which elicited a larger and enhanced activation in somatosensory input corresponding regions. (Ebert et al., “Increased Cortical Representation of the Fingers of the Left Hand in String Players.” SCIENCE 270 (1995), 305).
Somatosensory input from the lower limb has long been recognized as an important source of sensory information in controlling standing balance. (Fitzpatrick, R., Rogers, D. K. & McCloskey, D. I. (1994). Stable human standing with lower-limb muscle afferents providing the only sensory input. Journal of Physiology 480, 395-403; Allum, J. H. J., et al. “Age-dependent variations in the directional sensitivity of balance corrections and compensatory arm movements in man.” The Journal of physiology 542.2 (2002): 643-663). In addition, proprioceptive information from muscle spindles in muscles from around the knee and ankle may change joint angle relative to the trunk (Ivaneko, Y. P., Grasso, R. & Lacquaniti, F. (2000). Influence of leg muscle vibration on human walking. Journal of Neurophysiology 84, 1737-1747), while Golgi tendon organs may be responsible for force feedback about the loading of the body. (Pearson, K. G. (1995). Proprioceptive regulation of locomotion. (Review). Current Opinion in Neurobiology 5, 786-791). Finally, skin receptors in the foot sole are sensitive to contact pressures (Magnusson, M., Enbom, H., Johansson, R. & Pyykko, I. (1990). Significance of pressor input from the human feet in anteriorposterior postural control. The effect of hypothermia on vibration-induced body-sway. Acta Oto-Laryngolica 110, 182-188.) and may be sensitive to potential changes in the distribution of pressure. (Kavounoudias, A., Roll, R. & Roll, J. P. (1998). The plantar sole is a ‘dynamometric map’ for human balance control. NeuroReport 9, 3247-3252). Together, the integration of all these somatosensory inputs appears to provide important information about the body's position with respect to the supporting surface.
A wide variety of exercise devices exist to build strength of the user. These devices generally focus on increasing muscle strength, such as the abdomen, pectorals or biceps. In addition, therapeutic devices have been developed that build strength or increase flexibility to assist with the rehabilitation of a patient who has suffered an injury or medical procedure. There are currently a few exercise devices that have been developed to challenge the foot in a strength training way, such a shown in U.S. Pat. Nos. 4,461,472, 5,368,535 and U.S. Publ. No. 2011/0124473. However, there are no devices are known that exercise, stimulate, and train the somatosensory, proprioceptive neuromuscular re-education (SPNRED™) pathways that focus on digital movements (toes and fingers).
Over the past few decades many experts have advocated that stretching should last up to 30-60 seconds. However, prolonged static stretching actually decreases the blood flow within the tissue creating localized ischemia and lactic acid buildup. This can potentially cause irritation or injury of local muscular, tendinous, lymphatic, as well as neural tissues, similar to the effects and consequences of trauma and overuse syndromes. Performing an Active Isolated Stretch (AIS) of no longer than two seconds allows the target muscles to optimally lengthen without triggering the protective stretch reflex and subsequent reciprocal antagonistic muscle contraction as the isolated muscle achieves a state of relaxation. These stretches provide maximum benefit and can be accomplished without opposing tension or resulting trauma. Using a 2.0 second stretch has proven to be the key in avoiding reflexive contraction of the antagonistic muscle. Without activating muscle group contraction, restoration of full range of motion and flexibility can be successfully achieved. (Aaron Mattes, www.stretchingusa.com; Sherrington, C. S., Proc. Boy. Soc, 1897, 60, 414-417; Sherrington, C. S. The integrative action of the central nervous system, Yale University Press. 411 pp.; Sherrington, C. S., and Hering, E. S. Antagonistic muscles and reciprocal innervation. Fourth note. Pi-oc Boy. Soc, 1898, 62, 183-7).
Active Isolated Strengthening, Aaron Mattes Method 2006, Towel exercises Foot exercises pages 121 and 122, Foot Flexion, 1st, Supination, 2nd, Pronation 3rd. Citing Aaron Mattes' Active Isolated Strengthening: The Mattes Method (2006), we have identified and categorized these as non-weight bearing accessory exercises which is non-discriminatory (age/gender), versatile, and assists within varying types of exercise regimen (rehabilitative, season, or sport specific training). The three exercises are foot Pronation, Supination, and foot Flexion. As stated by Mattes (2006), these exercises are designed to help build arch strength, rehabilitate postoperative or post injury foot-ankle problems. The purpose is to strengthen the intrinsic muscles of the feet (Mattes, 2006). All three exercises utilize a towel as a tool to increase foot sensation and contact surface orientation and the use of a weight as resistance. The novel exercises train the coupled motions of the foot and ankle (talocrural, subtalar, and tarsometatarsal) joints: to increase range of motion (ROM) and strength when performing eversion and inversion, abduction and adduction, supination and pronation, dorsiflexion and plantar flexion. In addition they also train the toes (MPJ): flexion and extension, and abduction and adduction. Directly isolating and strengthening these movements while using neuromuscular proprioceptive techniques is an effective training style. The exercises are intended to mimic ankle movements during weight bearing activity but allow for isolated strengthening of the intrinsic musculature through progressive overload.
Research has shown that variations of the three novel exercises have been used to strengthen the intrinsic foot musculature. Jung et al. (2011) confirmed that the towel curl exercise is used to strengthen the Flexor Digitorum Longus (FDL) and Brevis (FDB), Lumbricales, and Flexor Hallucis Longus (FHL), (Jung D Y, Kim M H, Koh E K, Kwon O Y, Cynn H S, and Lee W H. (2011). A comparison in the muscle activity of the abductor hallicus and the medial longitudinal arch angle during toe curl and short foot exercise, Physical Therapy in Sport 12: 30-35, 2011). Potthast et al. supports these exercises because each exercise has an effect on toe flexion. (Potthast, et al., The Choices of Training Footwear Has an Effect on Changes: In Morphology and Function of Foot and Shank Muscles. 23 International Symposium on Biomechanics in Sports. Beijing-China, Aug. 22-27, 2005 (2005)). Toe flexion plays a large role in the training and maintenance of the transverse and both longitudinal arches. Robbins & Hanna (1987) support these exercises by previously stating that intrinsic muscles of the foot are responsible for maintaining the longitudinal arches of the foot. (Robbins, S., Hanna, A., (1987). Running-related injury prevention through barefoot adaptations. Medicine and Science in Sports and Exercise. 19(2): 148-156.)
Training inversion, the combination of plantar flexion, supination, and adduction, will train and maintain the Medial Longitudinal arch of the foot. Potthast et al. (2005) concluded that the increase in Plantar Flexion and Inversion strength in the experiment can be explained by the functional adaptations and ACSA of FHL and FDL. The evidence on Inversion training can be extrapolated to Eversion isolated training. Training Eversion, which is a combination of Dorsi Flexion, Pronation, and Abduction will train and maintain the Lateral Longitudinal arch of the foot. Properly training the intrinsic musculature of the lower extremity in a proprioceptive manner will stimulate the sensory receptors of the foot. Through strength adaptation pathways, the structures of the foot will become more prepared to withstand new biomechanical forces associated with barefoot activity and minimalist footwear use. (Jung D Y, Kim M H, Koh E K, Kwon O Y, Cynn H S, and Lee W H, A comparison in the muscle activity of the abductor hallicus and the medial longitudinal arch angle during toe curl and short foot exercise, Physical Therapy in Sport 12: 30-35, 2011; Potthast et al. (2005), The Choices of Training Footwear Has an Effect on Changes; In Morphology and Function of Foot and Shank Muscles. 23 International Symposium on Biomechanics in Sports. Beijing, China, Aug. 22-27, 2005; Robbins, S., Hanna, A., (1987), Running-related injury prevention through barefoot adaptations, Medicine and Science in Sports and Exercise, 19(2): 148-156).